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FNP Adult I > Adult I Final > Flashcards

Adult I Final Flashcards

Visual Changes

1
Q

A 75 y/o woman is concerned she may have to stop driving b/c of difficulty seeing on bright sunny days, and esp. at night with headlights. You recomm she see her optho and suggest most likely source of visual impairment is:

a) age related macular degeneration
b) cataract
c) glaucoma
d) uncorrected refractive error

A

b) cataract

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2
Q

Which of the following changes is NOT associated with aging?

a) miosis
b) lens yellowing
c) alterations in color vision
d) increased glare sensitivity and recovery
e) increased Intraocular pressure

A

e) increased intraocular pressure

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3
Q

What has been shown to NOT improve wet age-related macular degeneration?

a) laser photocoagulation
b) a hand magnifier
c) antioxidant vitamins
d) wearing a hat on bright sunny days

A

c) antioxidant vitamins

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4
Q

Most likely way older adults become blind?

a) Age Related Macular Degeneration (ARMD)
b) Glaucoma
c) Diabetic retinopathy

A

a) ARMD

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5
Q

Wet ARMD is called neovascular macular degeneration and accounts for 10% of ARMD cases and dry (non-neovascular) ARMD accounts for 90% T or F

A

T

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6
Q

Second-most leading cause of blindness?

A

POAG=primary open angle glaucoma

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7
Q

Risk of cataract development include:

a) low educational level
b) more hours in the sunlight
c) smoking
d) ETOH
e) All of the above

A

e) all of the above

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8
Q

Do vitamins or nutrition help cataracts?

A

No

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9
Q

Primary sx of cataracts?

A

Increased Glare

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10
Q

Macular degeneration causes a decrease in________________

A

central vision acuity

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11
Q

POAG causes degeneration in _____________and the leading cause of blindness in _____________

A

peripheral vision acuity, african-americans

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12
Q

Most common risk factors for occular disease

A

smoking and HTN

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13
Q

Most common visual loss associated with age?

A

Cataracts

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14
Q

Hallmarks of bacterial conjunctivitis include:

a) purulent discharge
b) conjunctive hyperemia and gluing of eyelids
c) a and b
d) a only

A

c) a and b

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15
Q

Viral conjunctivitis produces:

a) watery discharge
b) foreign body sensation
c) pre-auricular adenopathy
d) conjunctival follicles
e) pruritis
f) a,b,c,d

A

f) a,b,c,d

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16
Q

Etiology of bacterial conjunctivitis:

a) NG
b) haemophilus influenzae
c) streptococcus pneumoniae
d) moraxella catarrhalis
e) pseudomanas
f) a,b,c,d

A

f) a,b,c,d

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17
Q

Bacterial conjunctivitis will resolve with or without tx in 2-5 days 60% of the time T or F

A

true

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18
Q

Allergic Rhinitis is an ________mediated response

A

IgE

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19
Q

Best choice of OCP for breakthrough bleeding?

A

add estrogen

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20
Q

Best choice OCP for acne?

A

______________

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21
Q

What decreases the effectiveness of OCP?

a) HTN
b) smoking
c) weight gain
d) weight loss

A

c) weight gain

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22
Q

Important lab test prior to OCP start if FMhx cardiovascular disease?

A

Lipid panel

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23
Q

Prehypertension:

a) 122/79
b) 140/82
c) 134/90
d) 120/80

A

d) 120/80

prehypertension= 120-139/80-89

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24
Q 
Stage I HTN:
a) 159/92
b) 160/90
c) 140/88
d 144/90
A

d) 144/90

stage I= 140-159/90-99

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25
Q

Stage II HTN >______/________

A

Stage II >160/100

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26
Q

If a patient starts to have acute decline in renal function after starting an ACE, this may suggest:

a) primary HTN
b) secondary HTN
c) renal failure

A

b) secondary HTN

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27
Q

A change expected in an older patient with HTN:

a) increased peripheral vascular resistance
b) Decreased peripheral vascular resistance
c) Increased beta response
d) increased RAS response

A

a) increased peripheral vascular resistance w/ HTN

28
Q

First line Rx for Stg I HTN:

a) BB
b) Ca+ Channel Blockers
c) ACE
d) Thiazide diuretics

A

d) thiazide diuretics

29
Q

First line Rx for Stg II HTN:

a) 2 drug combo (thizaide + diuretic)
b) ARB
c) CCB
d) all of the above, starting with a

A

a) 2 drug combo (thiazide + diuretic)

30
Q 
Pt's with COPD
 should not be prescribed:
a) ACE inhibs
b) BB
c) CRB
d) ARB
A

b) BB

31
Q

CRBs can cause all except

a) peripheral edema
b) gingival hyperplasia
c) shouldn’t be used with impaired EF
d) diarrhea

A

d) CRBs cause constipation

32
Q

72 y/o black woman with HTN for many years and CHF. Best tx:

a) Thiazide diuretic
b) ARBs
c) ACE
d) CCB

A

c) ACE

33
Q

70 y/o man with DMII and HTN. Best Rx:

a) BB
b) ARB
c) BB
d) ACE

A

d) ACE

34
Q

fecal incontinence tx options:

a) biofeedback
b) Immodium
c) bentyl/dicyclomine
d) diapers

A

c) bentyl/dicyclomine

35
Q

constipation- most common type in the USa) DM

b) laxative abuse
c) Rx Meds
d) normal transit

A

d) normal transit (or functional constipation)

36
Q

Normal aging of the lower urinary tract includes:

a) bladder capacity decreases
b) residual urine volume increases
c) 10-20% of adults will have involuntary contractions of the bladder
d) 75% of elderly patients will have involuntary bladder contractions
e) all of the above

A

e) all of the above

37
Q

Drug therapy for urge incontinence is directed at:
relaxing smooth muscle at the base (trigone) of the bladder or by blocking the involuntary bladder contractions at the base

A

True

38
Q

Functional incontinence treatment:

a) diapers
b) Rx
c) BSC

A

c) BSC
functional (situational) incontinence is a manifestation of physical limitations or environmental barriers
(ie: diuretic adm- get BSC)

39
Q

Acute or transient incontinence can be temporary and D/T:

a) fecal impaction
b) hospitalization
c) delirium
d) anxiolytics
d) bed rails
e) all of the above

A

e) all of the above

40
Q

Unrelieved or new-onset constipation should be managed with:

a) laxatives
b) sigmoidoscopy/ba+ enema/or colonoscopy
c) EGD
d) FIT testing

A

b) sigmoidoscopy, ba+ enema or colonoscopy

41
Q

Constipation that is refractory and is accompanied by nausea, vomiting and abd pain should

a) be considered IBS
b) could signal intestinal obstruction

A

b) intestinal obstruction

42
Q

Which of the following does not contribute to constipation in adults?

a) PPI
b) CRB
c) Opioids
d) Calcium, FeSo4

A

a) PPIs

43
Q

Lab values to assess incontinence:

a) UA, UAC, CBC
b) UA, UAC, LFT’s
c) UA, UAC, BMP
d) UA, UAC, BMP, Ca+

A

d) UA, UAC, BMP, Ca+

44
Q

Best clinical tools for evaluating urinary incontinence: _________ & _____________

A

Comprehensive Hx and Physical Exam

45
Q

Incontinence that doesn’t resolve in _________ is considered chronic:

a) 4 weeks
b) 2 months
c) 6 months
d) 6 weeks

A

d) 6 weeks

46
Q

Most common type of urinary incontinence

a) overflow
b) stress
c) urge
d) psychogenic

A

c) urge

overflow most rare

47
Q

A PVR of >200ml is a sign of:

a) Overflow incontinence
b) UTI
c) BPH
d) Obstruction
e) a, c, e
f) a, b

A

e) a,c,e

48
Q

How to dx stress incontinence:

a) h/o any maneuver that increases abdominal pressure
b) direct observation of urinary loss when bearing down
c) PVR >200ml
d) a and b

A

d) a and b

49
Q

The initial tx for urge and stress incontinence should be ___________________

A

pelvic floor or Kegel exercises

50
Q

Neurogenic urge incontinence can best be relieved by:

a) Tricyclic antidepressants
b) Oxybutynin

A

a) tricyclics

oxybutynin can cause cognitive dysfunction 2/2 anticholinergic effects

51
Q

Stress incontinence is a result of:

a) stress
b) pelvic floor muscle weakness
c) atrophic vaginitis
d) b & c

A

b) caused by muscle weakness, but atrophic vaginitis can be contributory, so adding estrogen may be helpful

52
Q

Acute management of obstructive or overflow incontinence:

a) indwelling F/C
b) doxazosin
c) suprapubic catheter

A

c) for acute and urgent mgmt: suprapubic catheter will decompress the bladder

53
Q

The following drugs can cause incontinence except:

a) narcotics
b) hyponotics
c) antipsychotics and antidepressants
d) CCB
e) BBs

A

e) beta blockers

54
Q

Which drugs cross the blood-brain barrier and cause significant cognitive dysfunction in older adults?

a) trospium
b) oxybutynin
c) tolterodine
d) darifenacin

A

c) tolterodine

55
Q

Most common predisposing cause ofn UTI’s:

______________________

A

cognitive dysfunction

56
Q

The most appropriate tx of a pt with a UTI in the presence of a bladder stone is:

a) trial of ABX
b) surgically remove the stone
c) lifelong tx with ABX
d) indwelling F/C with irrigation

A

b) surgically remove the stone

57
Q

Complications of F/C include nephrolithiasis

T or F

A

True

58
Q

Acne
Headache
Nausea
Spotting

A

OCP methods to manage:
Acne low androgenic to progestin ratios (drospirenone) or mod-high estrogen contents relieve acne and block excessive hair growth. Ortotricyline triphasic norgestimate, alese and Yaz are approved for tx of acne

Headaches if 2/2 fluid excess, switch to lower estrogen. Worsening migraines, d/c OCPs

Nausea r/t estrogen w/ food@ HS or low estrogen OCPs

BTB most common with low dose combo OCs and progestin only pills.. Most common during first few cycles and usu takes time for the endometrium to adjust. If BTB early (before 10th day) insufficient estrogen. If after the 10th day insufficient progestin. Could also 2/2 imbalance b/w estrogen & progestin, missed pills, drug interaction, endo resistance, infection, smoking

59
Q

FOOSH Injuries include
coole’s (distal radius)
scaphoid (snuff box)

A

Elderly
may be 1st sign of OP
young, athlete

60
Q

Tests for
ACL
MCL
LCL

A 
ACL= anterior drawer test
MCL= valgus (medial)
LCL= varus (lateral)
61
Q

For Achiles Tear:
a) Have pt lie prone, with feet hanging off table
b) Palpate tendon (tenderness 2-6 cm above insertion)
c) Have pt dorsiflex, plantarflex (decreased/unable if tear)
d)Thompson test/calf squeeze:
Normal=plantarflex (may occur in partial)
Abnormal=unable, complete tear
e) all of the above
�

A

e) all of the above

62
Q

S/S FeSo4 deficiency anemia:

a) skin/conjunctival pallor
b) koilonchias (spoon nails)
c) pica
d) pagophagia (eating ice)
e) blue sclera
f) all of the above

A

f) all of the above

63
Q

What type of anemia?

a) Thalassemia
b) Anemia of chronic disease
c) lead poisoning
d) Sickle cell
e) iron-deficiency anemia
f) sideroblastic

A

microcytic anemia

sideroblastic can be either macro or micro

64
Q

B12 deficiency anemia indices:

a) Reticulocyte count high
b) MCV elevated
c) leukocytosis
d) neuro effects resolve with tx

A

retic count low to normal (not high)
MCV elevated, macrocytic
leukopenia present (not leukocytosis)
neuro effects may not always resolve w/ tx

65
Q

Folic Acid deficiency:

a) microcytic
b) macrocytic

A

macrocytic

FNP Adult I (1 decks)

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